NSG 223 Med Surg 2 HESI Final Exam 2026 | Most Tested Questions
& Verified Answers with Bold Italic Explanations | Study Guide
Chamberlain University
NSG 223 Med Surg 2 HESI Final Exam provides most tested practice
questions with verified answers and bold italic explanations covering all
core domains including cardiovascular, respiratory, gastrointestinal,
renal, endocrine, neurological, hematologic, musculoskeletal,
perioperative, and comprehensive prioritization. Each question is followed
immediately by its correct answer and detailed rationale, making it ideal
for focused review and quick retention. This updated 2026 study guide is
designed for Herzing University NSG 223 students and sellers on Stuvia
and Docsity.
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1–35)
1. A client with acute coronary syndrome reports chest pressure,
diaphoresis, and nausea. Which action should the nurse take FIRST?
A) Administer aspirin
B) Obtain a 12-lead ECG
C) Assess airway, breathing, circulation, and vital signs
D) Prepare for cardiac catheterization
Answer: C) Assess airway, breathing, circulation, and vital signs
***Explanation: Initial assessment of ABCs and vital signs is the priority
for any client with potential acute coronary syndrome. ECG, aspirin, and
catheterization follow assessment. ***
,2. A client with heart failure has crackles, 3+ pitting edema, and a
BNP of 1600 pg/mL. Which medication should the nurse anticipate
FIRST?
A) Metoprolol
B) Digoxin
C) IV furosemide
D) Spironolactone
Answer: C) IV furosemide
***Explanation: Acute decompensated heart failure with pulmonary
congestion and edema requires rapid fluid removal with an IV loop
diuretic such as furosemide. ***
3. A client is receiving a continuous heparin infusion for a DVT.
Which laboratory value should the nurse monitor to evaluate
therapeutic effectiveness?
A) INR
B) aPTT
C) Platelet count
D) Hemoglobin
Answer: B) aPTT
***Explanation: Heparin therapy is monitored using the activated partial
,thromboplastin time (aPTT). The therapeutic goal is typically 1.5 to 2.5
times the normal control value. INR is used for warfarin monitoring. ***
4. A client with heart failure is prescribed furosemide. Which
electrolyte imbalance should the nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia
Answer: B) Hypokalemia
***Explanation: Furosemide is a loop diuretic that causes significant
potassium loss, leading to hypokalemia. The nurse should monitor serum
potassium levels and assess for muscle weakness, cardiac arrhythmias,
and fatigue. ***
5. A client is 24 hours post-myocardial infarction. Which finding
requires immediate nursing intervention?
A) Chest pain rated 3/10
B) Heart rate of 92 bpm
C) Crackles in the lung bases
D) Oxygen saturation of 94%
, Answer: C) Crackles in the lung bases
***Explanation: Crackles in the lung bases indicate pulmonary congestion,
which may be a sign of acute heart failure, a common complication of MI.
This requires immediate intervention including assessment of fluid status,
diuretics, and oxygen therapy. ***
6. A client with heart failure is prescribed metoprolol. Which
instruction is MOST important?
A) Take the medication only when symptomatic
B) Do not stop the medication abruptly
C) Take with potassium supplements
D) Expect a rapid heart rate
Answer: B) Do not stop the medication abruptly
***Explanation: Abrupt discontinuation of beta-blockers can cause
rebound tachycardia, hypertension, and angina. Clients must be taught to
taper gradually under medical supervision. ***
7. A client develops sudden shortness of breath, pleuritic chest pain,
and tachycardia after surgery. What is the priority nursing action?
A) Ambulate the client
B) Administer oxygen and notify the provider
& Verified Answers with Bold Italic Explanations | Study Guide
Chamberlain University
NSG 223 Med Surg 2 HESI Final Exam provides most tested practice
questions with verified answers and bold italic explanations covering all
core domains including cardiovascular, respiratory, gastrointestinal,
renal, endocrine, neurological, hematologic, musculoskeletal,
perioperative, and comprehensive prioritization. Each question is followed
immediately by its correct answer and detailed rationale, making it ideal
for focused review and quick retention. This updated 2026 study guide is
designed for Herzing University NSG 223 students and sellers on Stuvia
and Docsity.
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1–35)
1. A client with acute coronary syndrome reports chest pressure,
diaphoresis, and nausea. Which action should the nurse take FIRST?
A) Administer aspirin
B) Obtain a 12-lead ECG
C) Assess airway, breathing, circulation, and vital signs
D) Prepare for cardiac catheterization
Answer: C) Assess airway, breathing, circulation, and vital signs
***Explanation: Initial assessment of ABCs and vital signs is the priority
for any client with potential acute coronary syndrome. ECG, aspirin, and
catheterization follow assessment. ***
,2. A client with heart failure has crackles, 3+ pitting edema, and a
BNP of 1600 pg/mL. Which medication should the nurse anticipate
FIRST?
A) Metoprolol
B) Digoxin
C) IV furosemide
D) Spironolactone
Answer: C) IV furosemide
***Explanation: Acute decompensated heart failure with pulmonary
congestion and edema requires rapid fluid removal with an IV loop
diuretic such as furosemide. ***
3. A client is receiving a continuous heparin infusion for a DVT.
Which laboratory value should the nurse monitor to evaluate
therapeutic effectiveness?
A) INR
B) aPTT
C) Platelet count
D) Hemoglobin
Answer: B) aPTT
***Explanation: Heparin therapy is monitored using the activated partial
,thromboplastin time (aPTT). The therapeutic goal is typically 1.5 to 2.5
times the normal control value. INR is used for warfarin monitoring. ***
4. A client with heart failure is prescribed furosemide. Which
electrolyte imbalance should the nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia
Answer: B) Hypokalemia
***Explanation: Furosemide is a loop diuretic that causes significant
potassium loss, leading to hypokalemia. The nurse should monitor serum
potassium levels and assess for muscle weakness, cardiac arrhythmias,
and fatigue. ***
5. A client is 24 hours post-myocardial infarction. Which finding
requires immediate nursing intervention?
A) Chest pain rated 3/10
B) Heart rate of 92 bpm
C) Crackles in the lung bases
D) Oxygen saturation of 94%
, Answer: C) Crackles in the lung bases
***Explanation: Crackles in the lung bases indicate pulmonary congestion,
which may be a sign of acute heart failure, a common complication of MI.
This requires immediate intervention including assessment of fluid status,
diuretics, and oxygen therapy. ***
6. A client with heart failure is prescribed metoprolol. Which
instruction is MOST important?
A) Take the medication only when symptomatic
B) Do not stop the medication abruptly
C) Take with potassium supplements
D) Expect a rapid heart rate
Answer: B) Do not stop the medication abruptly
***Explanation: Abrupt discontinuation of beta-blockers can cause
rebound tachycardia, hypertension, and angina. Clients must be taught to
taper gradually under medical supervision. ***
7. A client develops sudden shortness of breath, pleuritic chest pain,
and tachycardia after surgery. What is the priority nursing action?
A) Ambulate the client
B) Administer oxygen and notify the provider
